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General NPI Number Information
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NPI Number | 1053618272
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Entity Type | Organization
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Legal Business Name | HEALTHSPAN INC.
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Dates
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Enumeration Date | 02/24/2011
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Last Update Date | 12/28/2015
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Provider Practice Location Address
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Address Line | 225 PICTORIA DR STE 320
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City | CINCINNATI
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State | OH
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Zip | 45246-1616
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Country | US
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Telephone | 513-551-1500
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Fax | 513-551-1489
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Provider Business Mailing Address
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Address Line | 225 PICTORIA DR STE 320
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City | CINCINNATI
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State | OH
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Zip | 45246-1616
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Country | US
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Telephone | 513-551-1500
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Fax | 513-551-1489
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Authorized Official
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Title or Position | DIRECTOR
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Name | JANE HAWKINS
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Credential |
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Telephone | 513-551-1480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | E.0002735
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License Number State | OH
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